Liver Transplantation for Hepatocellular Carcinoma: Past, Present and Future

Hepatocellular carcinoma (HCC) represents one of the most common neoplasms worldwide. Liver trasnplantation (LT) is the treatment of choice for selected group of patients with HCC. LT is actually a consolidated therapeutic option for HCC because it cures both tumor and underlying cirrhosis. In 1996, the publication of a pivotal prospective study on less than 50 patients, transplanted for HCC under predefined criteria (single HCC ≤ 5 cm or 3 HCC ≤ 3 cm each), the so called “Milan criteria”, showed a 4-year survival of 75%. However, the indication of LT for HCC treatment has evolved over recent years. The possibility of an extension of Milan criteria as indication for LT is already a debated issue. Living donor LT (LDLT) is an alternative option if waiting list is long and offers the possibility of a LT after a short time. In this review, the current indications and results of liver transplantion for HCC have been dsicusssed.